Treatment patterns and clinical interventions in pediatric dental emergencies during COVID-19

Abstract Background While COVID-19’s impact on dental services has been widely studied, limited research exists on how the pandemic altered clinical decision-making and treatment selection in pediatric dental emergencies. This study examined changes in treatment patterns and clinical interventions f...

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Main Authors: Michael V. Joachim, Dana Atia Joachim, Ephraim Shapiro, Andy Ariel Boiangiu, Thabet Asbi, Doron Haim
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06506-0
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author Michael V. Joachim
Dana Atia Joachim
Ephraim Shapiro
Andy Ariel Boiangiu
Thabet Asbi
Doron Haim
author_facet Michael V. Joachim
Dana Atia Joachim
Ephraim Shapiro
Andy Ariel Boiangiu
Thabet Asbi
Doron Haim
author_sort Michael V. Joachim
collection DOAJ
description Abstract Background While COVID-19’s impact on dental services has been widely studied, limited research exists on how the pandemic altered clinical decision-making and treatment selection in pediatric dental emergencies. This study examined changes in treatment patterns and clinical interventions for pediatric dental emergencies during the COVID-19 lockdown, aiming to understand how crisis conditions influence clinical approaches and treatment outcomes. Methods This retrospective study analyzed 6,024 emergency dental visits of children under 12 years across three distinct periods: pre-COVID (March-May 2019), during first lockdown (March-May 2020), and post-lockdown (March-May 2021). Data were collected from electronic dental records of a major Israeli healthcare provider operating 50 dental clinics. Treatment categories were classified as conservative (medication only, temporary restorations) or invasive (extractions, pulp therapy). Statistical analysis included chi-square tests for treatment distribution comparisons and multivariate logistic regression to evaluate factors influencing treatment selection, adjusting for age, sex, and presenting conditions. Results During lockdown, invasive treatments increased significantly, with extraction rates rising from 18.4 to 24.8% and pulp therapy from 12.2 to 15.6% (p < 0.001). Pharmaceutical-only interventions decreased from 44.6 to 22.4%. Multivariate analysis revealed higher odds of receiving invasive treatment during lockdown (OR = 1.82, 95% CI: 1.54–2.15) compared to pre-COVID period, even after adjusting for presenting conditions. The trend toward invasive treatments persisted but moderated in the post-lockdown period, with rates returning closer to pre-pandemic levels (19.2% for extractions, 11.8% for pulp therapy). Treatment planning showed a significant shift from conservative to invasive interventions during lockdown, with conservative treatments (pharmaceutical management, temporary and permanent restorations) decreasing from 89.6 to 56.1%, while invasive treatments (pulp therapy, extractions, drainage) increased correspondingly. Conclusions The pandemic crisis was associated with shifts in treatment patterns, favoring definitive interventions over temporary solutions. This change in clinical decision-making patterns suggests a crisis-induced adaptation in treatment planning, potentially influenced by uncertainty about future care accessibility. These findings provide important insights for developing clinical guidelines for pediatric dental emergency care during future healthcare crises. Clinical trial number Not applicable.
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spelling doaj-art-edeab568f07c482b85e72a5231d13a942025-08-20T04:01:42ZengBMCBMC Oral Health1472-68312025-07-0125111010.1186/s12903-025-06506-0Treatment patterns and clinical interventions in pediatric dental emergencies during COVID-19Michael V. Joachim0Dana Atia Joachim1Ephraim Shapiro2Andy Ariel Boiangiu3Thabet Asbi4Doron Haim5Goldschleger School of Dental Sciences, Gray Faculty of Medical and Health Sciences, Tel Aviv UniversityDepartment of Health Systems Management, Ariel UniversityDepartment of Health Systems Management, Ariel UniversityAdelson School of Medicine, Ariel UniversityMaccabi-Dent Research DepartmentMaccabi-Dent Research DepartmentAbstract Background While COVID-19’s impact on dental services has been widely studied, limited research exists on how the pandemic altered clinical decision-making and treatment selection in pediatric dental emergencies. This study examined changes in treatment patterns and clinical interventions for pediatric dental emergencies during the COVID-19 lockdown, aiming to understand how crisis conditions influence clinical approaches and treatment outcomes. Methods This retrospective study analyzed 6,024 emergency dental visits of children under 12 years across three distinct periods: pre-COVID (March-May 2019), during first lockdown (March-May 2020), and post-lockdown (March-May 2021). Data were collected from electronic dental records of a major Israeli healthcare provider operating 50 dental clinics. Treatment categories were classified as conservative (medication only, temporary restorations) or invasive (extractions, pulp therapy). Statistical analysis included chi-square tests for treatment distribution comparisons and multivariate logistic regression to evaluate factors influencing treatment selection, adjusting for age, sex, and presenting conditions. Results During lockdown, invasive treatments increased significantly, with extraction rates rising from 18.4 to 24.8% and pulp therapy from 12.2 to 15.6% (p < 0.001). Pharmaceutical-only interventions decreased from 44.6 to 22.4%. Multivariate analysis revealed higher odds of receiving invasive treatment during lockdown (OR = 1.82, 95% CI: 1.54–2.15) compared to pre-COVID period, even after adjusting for presenting conditions. The trend toward invasive treatments persisted but moderated in the post-lockdown period, with rates returning closer to pre-pandemic levels (19.2% for extractions, 11.8% for pulp therapy). Treatment planning showed a significant shift from conservative to invasive interventions during lockdown, with conservative treatments (pharmaceutical management, temporary and permanent restorations) decreasing from 89.6 to 56.1%, while invasive treatments (pulp therapy, extractions, drainage) increased correspondingly. Conclusions The pandemic crisis was associated with shifts in treatment patterns, favoring definitive interventions over temporary solutions. This change in clinical decision-making patterns suggests a crisis-induced adaptation in treatment planning, potentially influenced by uncertainty about future care accessibility. These findings provide important insights for developing clinical guidelines for pediatric dental emergency care during future healthcare crises. Clinical trial number Not applicable.https://doi.org/10.1186/s12903-025-06506-0Pediatric dentistryEmergency dental careCOVID-19Treatment patternsClinical decision-makingInvasive dental procedures
spellingShingle Michael V. Joachim
Dana Atia Joachim
Ephraim Shapiro
Andy Ariel Boiangiu
Thabet Asbi
Doron Haim
Treatment patterns and clinical interventions in pediatric dental emergencies during COVID-19
BMC Oral Health
Pediatric dentistry
Emergency dental care
COVID-19
Treatment patterns
Clinical decision-making
Invasive dental procedures
title Treatment patterns and clinical interventions in pediatric dental emergencies during COVID-19
title_full Treatment patterns and clinical interventions in pediatric dental emergencies during COVID-19
title_fullStr Treatment patterns and clinical interventions in pediatric dental emergencies during COVID-19
title_full_unstemmed Treatment patterns and clinical interventions in pediatric dental emergencies during COVID-19
title_short Treatment patterns and clinical interventions in pediatric dental emergencies during COVID-19
title_sort treatment patterns and clinical interventions in pediatric dental emergencies during covid 19
topic Pediatric dentistry
Emergency dental care
COVID-19
Treatment patterns
Clinical decision-making
Invasive dental procedures
url https://doi.org/10.1186/s12903-025-06506-0
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